China CDC Weekly Healthy China Construction and Implementation of Big Data in Healthcare in Yichang City, Hubei Province Fangfang Lu1; Chengzhong Xu1; Pei Zhang1; Yong Xu1,#; Jianhua Liu1,# explore the construction of a big data platform from Summary 2014, formed the current platform in 2016, and Environmental pollution, aging, emerging infectious consistently improved it over the last 3 years. diseases, and unhealthy lifestyles are affecting human The government-led Yichang Healthcare Big Data health and resulting in serious social and economic Center adopts the cloud model under an urban burdens. The government-led healthcare big data framework that breaks barrier of information sharing platform in Yichang has continuously worked towards among different sectors (Figure 1) in China for the first exploring the use of comprehensive health-related time (5–6). There are over 4 billion pieces of stored information through top-level design and scientific data in Yichang Healthcare Big Data Center and more planning. The platform is based on the following than 1.8 million pieces of data being generated daily principle: “Openness, inclusiveness, and win-win covering all 13 counties and districts and the 4.1 cooperation.” So far, by relying on one-to-one million residents. The Yichang regional public health verification, comparison, correlation, and correction information platform passed the Assessment of with the source, the platform has succeeded in Standardization Maturity of National Medical and establishing a unique foundation to benefit the people, Health Information Interconnection and achieved the government, medical care, and health service. Its highest grades. After nearly four years of practice and successes can hopefully act as a positive case for exploration, disease discovery and reporting and health exploring domestic healthcare big data. management and delivery has changed dramatically. Based on one-to-one sources and information To solve challenges brought forth by economic sharing, new technologies such as artificial intelligence development, social transformation, environmental were used to monitor and report specified infectious pollution, aging, and poor lifestyles on population diseases, tumors, cardiovascular and cerebrovascular health and disease burdens, Healthy China 2030 Plan events, hypertension, and diabetes in real time (Figure 2). proposed promoting the application of healthcare and Figure 3 shows the in-patient and out-patient medical big data (1). The Chinese government also admission among total and special populations lists the application and development of healthcare big (children under 5 years old, middle school students, data as an important national task (2). The Alibaba and people older than 65 years old), number of Health Strategy Platform (3), Tencent Smart Medical vaccinations, 4 categories of disease event reports Platform, and regional healthcare big data centers (4) (cardiovascular and cerebrovascular diseases, tumors, such as Shanghai, Ningbo, Fujian, and Jiangsu have causes of death, and infectious diseases), daily births emerged to explore how big data can help solve and deaths, and other medically related events (for problems people encounter in their everyday lives. example, first-aid, blood donation and transfusion). It Lying in the western part of China’s Hubei also outlines the follow-up of hypertension and Province, Yichang City is located at the conjunction of diabetes required by Basic Public Health Services. the middle and upper reaches of the Yangtze River. Yichang’s healthcare big data platform has Yichang has five districts, three county-level townships, transformed the city’s data collection, integration, five counties and one national-level high-tech zone. It sharing, and analysis of population health and health- covers an area of 21,000 square kilometers and has a related information, which contains medical and population of 4.1379 million, including a registered environmental indicators, birth and death registrations, population of 3.9094 million. As one of the first insurance claims, and other important health National Pilot City and Healthy City Using indicators. Successful information sharing among Information to Benefit the People, Yichang began to different departments is meaningful for policymaking 14 CCDC Weekly / Vol. 3 / No. 1 Chinese Center for Disease Control and Prevention China CDC Weekly Full coverage services (Data+Application) Payment Pharmaceutical platform Comprehensive supervision company Whole chain business Commercial Health insurance E-business collaboration Public insurance security MCH Operators NHC Community Unified Standardized Bank Emergency center Logistics CDC One card People Government Full service Insurance claims Physical center Hospital Medical & health management needs Medical Policy Industry Integrated smart health FIGURE 1. The regionally integrated smart healthcare big data platform in Yichang, Hubei province, 2020. Anxiety state Iumbar Gastritis COPD Abactio Gyne disc cology Rhinits Vaccina… Insomnia hemiation Coronary heart disease Urinary Urinary infection Gerebral system Xerophthsimia Diabetes infarction infection Thyrold Phary dyefun mgitis Const… Chronic… Antenatal ction Somnipathy care Acute throat Health infection HYpertension examination Osphyalgia Pregnant Metrorrhagia Hypothy Impacted state Antenatal roidism tooth care Trachelitis Dermatitis Irregular Carbunculosis Eczema menstruation Infertinity Acute Upper respiratory bronchitis Acne Thy… Pros… Brea… infection Vaginosis Conjunctivitis Bronchitis Hyperlipemia Acute Ametropia Asteoporosis rhinitis Myopia Hypertension visits of outpatient Hypertension visits of outpatient in different hospitals 35,000 (in the last year) (in the last year) 30,000 Gezhouba Central Hospital Yichang Central People’s Hospital Affiliated Renhe Hospital of the Three Gorges Universily 25,000 20,000 The First People’s Hospital of Yichang 15,000 The Second People’s Hospital of Yichang 10,000 Yichang Special careHospital The Third People’s Hospital of Yichang Yichang’s Chinese Traditional Medical Hospital Yichang Women’s & Children’s Hospital 5,000 The Community Health Centers 0 201908 201908 201908 201910 201912 202001 202002 202003 202004 202005 202006 202007 Age group of hypertension visits Area of hypertension visits 18,000 (in the last year) (in the last year) 15,000 12,000 9,000 6,000 2,889 3,000 0 5-14 15-44 45-59 60+ 0 Visits FIGURE 2. The monthly out-patient admissions of Yichang City displayed in real-time on the Healthcare Big Data Platform, Hubei Province, 2020. and resource allocation. Many innovations have been infectious diseases, hypertension, diabetes, tumors, made, especially in disease monitoring, health cardiovascular and cerebrovascular events have been management, and “healthy city” construction. First, developed. Similar systems can lay a solid foundation intelligent discovery and reporting systems of notifiable for the full coverage of disease monitoring on health Chinese Center for Disease Control and Prevention CCDC Weekly / Vol. 3 / No. 1 15 China CDC Weekly FIGURE 3. Healthcare big data information integration display platform in Yichang City, Hubei Province, 2020. risk factors, diagnosis, treatment, etc. and allow for detection platform, short message reporting platform, deep exploration of disease occurrence and and the grid agent reporting system to collect development. Second, combined with personal information including dynamic temperature data and electronic health records and mobile applications, a full information of key prevention and control personnel lifecycle and full chain of healthcare information including those returning or coming to Yichang, application platform can be built for all permanent members of these families, close contacts, and pyrexia residents. Third, integrated department data will also patients. Intelligent prevention and control programs benefit “healthy city” construction by allowing for were set up for different personnel and automatically enhanced urban construction planning and city health distributed to each township and urban neighborhood evaluation. Functions and advantages of healthcare big office for isolation management and medical data on emergent events of public health such as the observation. The dynamic supervision applied in urban coronavirus disease 2019 (COVID-19) pandemic, areas in Yichang has avoided heavy and complicated which emerged in Hubei Province, were also crucial to reports, provided strong evidence for emergency the response. management and early warnings, and allowed for One of the most efficient ways to prevent the spread closed-loop management of all personnel. and prevalence of disease is to carry out a detailed and By using the aspects of the big data platform for thorough epidemiological investigation to uncover the patient data, improvements in timeliness, accuracy, characteristics of outbreaks. The onset time, and integrity of data can be tracked and displayed. symptoms, diagnosis, treatment, laboratory testing, Missing, delayed, and repeated reports can be results, underlying diseases of the patient, the prevented. The medical records of patients who were departments and doctors involved, and other helpful diagnosed as COVID-19 in the big data platform were information can be obtained from the healthcare big also useful for doctors to make more informed data platform to help quickly ascertain the index case, treatment plans. disease characteristics, susceptible populations, and In the big data